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Pancreatic Cancer

Pancreas is an organ in the abdomen behind the lower part of your stomach which releases enzymes that aid digestion and hormones that help manage your blood sugar. Cancer that begins in the tissues of your pancreas is called pancreatic cancer. This cancer typically spreads rapidly to nearby organs. It is uncommonly detected in its early stages. But people having pancreatic cysts or a family history of pancreatic cancer, some tests might help detect a problem at its early stage.

Pancreatic cancer is mainly depends on the exocrine or endocrine functions of the pancreas. The most common type of pancreatic cancer is when tumors affect the exocrine functions. These tumors or cysts are benign, called cystadenomas. It is more likely to find adenocarcinomas (malignant tumors) that typically start in gland cells in the ducts of the pancreas, but they can also arise from pancreatic enzyme cells (acinar cell carcinoma).

Adenosquamous carcinomas, squamous cell carcinomas, and giant cell carcinomas, are other types of pancreatic cancers that are associated with exocrine functions. The ampullary cancer (carcinoma of the ampulla of Vater) that starts where the bile duct and pancreatic duct meet the duodenum of the small intestine is also a malignant disease.

Neuroendocrine or islet cell tumors are fairly uncommon tumors that affect the endocrine functions of the pancreas. Functioning islet cell tumors still can make hormones, while non-functioning ones do not make hormones. Most of these tumors are benign, but non-functioning tumors are more likely to be malignant, islet cell carcinomas.

Smoking can increase the risk of pancreatic cancer, pancreatitis(inflammation of the pancreas), diabetes, family history of pancreatic cancer, over-weight, age are few factors that can increase or cause the pancreatic cancer.

Pancreatic cancer is aggressive type of cancer and their symptoms may include pain in the abdomen, unusual weight loss, diarrhea, fever and jaundice, low mood or depression, indigestion, pale and smelly stools, mid back pain, pain on eating, tiredness.

It can be diagnosed through imaging tests, MRI, CT scan, ultrasound, cholangiopancreatography, somatostatin receptor, scintigraphy (SRS) positron emission tomography (PET) scan, angiography, blood tests, and biopsy as suggested by doctors.

Pancreatic cancer can be treated through surgery, chemotherapy, and radiation depending on its stage how far has it gone, patient’s health and other factors.

Whipple Surgery For Pancreatic Cancer:

Pancreaticoduodenectomy, commonly known as whipple surgery is the most common operation of the endocrine pancreas in which the head of the pancreas, a portion of bile duct, gallbladder, duodenum, lymph nodes near the pancreas and some time a part of stomach is also removed. The remaining pancreas, bile duct and intestine are sutured back into the intestine so that bile and digestive enzymes can still go into the gut and small intestine pieces are then reattached so that food can pass through the digestive tract. This surgery is done through a large cut down the belly and can be done through laparoscopic operation also known as keyhole surgery. It is complex procedure with a high risk of life threatening complications which requires a skilled and experienced surgeon.

In pylorus preserving pancreatoduodectomy (PPPD) procedure only part of the duodenum is removed and pylorus (stomach part that connects to the duodenum) is kept which may help in digesting food after the operation. This surgery also has high risk and complications. This procedure is a modified whipple’s surgery.

Patients may have immediate risks and complications which may include bleeding, infections, leaking of digestive enzymes, inflammation of pancreas, trouble defecating, weight loss, changes in bowel movements, developing diabetes and possibility of organ failure including the heart, liver and kidneys.

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